During surgical procedures and, more particularly, tissue removal procedures, it is desirable to limit the size of the entry incision to minimize the trauma experienced by the patient. In the past, efforts to minimize entry incision size have generally been limited due to the size of the tissue to be removed and the need for access to the tissue.
However, in modern surgery access to the tissue cite is provided by inserting one or more trocar and cannula. Thereafter, one or more laparoscopes are used to view the tissue to be removed, and additional port sites are used to gain access to the tissue to sever it from tissue which is to remain. However, the entry incision must still be sized to allow removal of the severed tissue and, therefore, the reduction in entry incision size is rather limited even in more modern or recently developed surgical procedures.
Morcellators are devices that morcellate or cut tissue into smaller pieces to allow for easier removal through small surgical access sites. Morcellators that require a pushing or downward traction operation to cut the tissue present a danger of over extension into tissue that is not to be injured. By way of example, but not limited thereto, in a laparoscopic subtotal hysterectomy, one way of minimizing the danger of this over extension is to amputate the body of the uterus from the cervix prior to morcellation. The amputation of the uterus presents an added risk of injury to other organs, such as the rectum and bowel, as they lie behind the uterus and are difficult to see during uterus amputation. Also, amputation is commonly performed using electrocautery or harmonic scalpel which may cause lateral spread of heat or other energy and can inadvertently cause a burn to the bowel or bladder that may not be realized until days after surgery. Further, amputation of the uterus requires the use of one surgical instrument to amputate the uterus and another surgical instrument to morcellate the uterus with their associated cost and complexity of use.
Some known laparoscopic supracervical hysterectomy instruments utilize graspers that pull tissue into a spinning tubular blade or the spinning blade is pushed into the tissue. These types of instruments have their limitations and dangers associated with their use, such as, but not limited to, the exposed sharp blade possibly injuring surrounding tissue not intended to be morcellated, discharge of the tissue in a spinning tool, and the difficulty and dangers of placing downward traction into the target tissue.
There exists a need in the art for surgical devices and methods that allow for more effective tissue severing and morcellating and which allow for morcellation without the need to first amputate the tissue.